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Esophageal motility studies in cirrhotic patients before and after endoscopic variceal ligation

BACKGROUND: To study esophageal motility before and after the endoscopic variceal ligation in cirrhotic patients. METHODS: Twenty-four patients with chronic liver disease assisted at the "Gastrocentro - UNICAMP" in the program of endoscopic variceal ligation were studied (mean age of 49.5 years, 19 males and 5 females). The inclusion criteria were chronic liver disease and esophageal varices with high-risk bleeding. Initially upper digestive endoscopy and esophageal manometry were performed in all cases. Next, the sessions of variceal ligation were initiated (average 3.4±2.1) in the outpatient clinic, with an interval of 2 to 4 weeks. The esophageal manometry was repeated 4 weeks after variceal eradication and amplitude, duration, propagation speed of the contractile waves and peristalsis were studied. RESULTS: Analysis of the lower sphincter pressure did not show differences before and after variceal ligation. In 10 cases (41.6%) dysmotility was recorded, and the amplitude of the contractile waves rose from 70.7 mmHg (52.3 and 108.4) before variceal ligation to 89.7 mmHg (69.9 and 122.8) after the procedure (p = 0.004 - p <0.05), and the duration increased from 3.55 seg.± 0.58 to 3.90 seg.± 0.72 (p=0.02 - p <0.05). The wave propagation speed did not differ from the values before the exam of 3.43± 0.97cm/seg, to those after of. 61± 0.99 cm/sec (p=0.15 - p>0.05). CONCLUSION: The final analysis shows alterations of esophageal motility characterized by increase in the amplitude and duration of the contractile waves.

Esophageal varices; Digestive endoscopy; Liver cirrhosis; Esophageal motility


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